ABSTRACT
Background: With the highly effective direct-acting antiviral (DAA) therapy, the number of liver transplants for hepatitis C virus (HCV) has decreased worldwide. However, similar to the phenomenon occurring in COVID-19 infection, the residual virus reservoirs in target organ is warranted to be explored due to the potential replication and disease recurrence. Hence, we aim to investigate the significance of hepatic HCV RNA identification as well as the discrepancy between HCV RNA and HCV core antigen (HCV Ag) in native liver of chronic hepatitis C recipients undergoing living donor liver transplantation (LDLT). Methods: Between Feb 2016 to Aug 2019, we prospectively enrolled 80 serum anti-HCV positive recipients who underwent LDLT. HCV RNA extracted from the native liver tissues was subjected to one-step reverse transcribed qPCR, using the TopScript One Step qRT PCR Probe Kit with HCV qPCR probe assay and human GAPDH qPCR probe assay on ViiA 7 Real Time PCR System. Hepatic HCV Ag was identified from the native liver tissues by employing the qualitative enzyme immunoassay technique. All experimental steps were based on the protocol provided by Human HCV Ag ELISA Kit (Cat. No. MBS167758). Results: Among 80 recipients, 85% (68/80) positive HCV-RNA was significantly higher in the native liver tissues than in the serum before (29/80, 36.3%;p = 0.000) and after LDLT (3/80, 4.4%;p = 0.000). In contrast, hepatic HCV Ag was 100% negative identified in all 80 explanted native liver. Conclusions: Significant positive HCV-RNA identification in the native liver suggested that pre-LDLT serum HCV RNA should be underestimated in the real status of HCV activity. HCV Ag assay may have lack of sensitivity and negative predictive value in liver tissues. In contrast to serum HCV RNA and HCV Ag, a great discrepancy might be described between hepatic HCV RNA and HCV Ag in the liver tissue. (Figure Presented).